Weight Loss-Induced Reduction of Bone Mineral Density in Older Adults with Obesity

Abstract

Obesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m² and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases total hip bone mineral density and increases the risk of frailty fractures (composite of proximal femur, pelvis, and proximal humerus fractures). Randomized controlled trials have largely confirmed these earlier observations but have also shown that exercise, particularly progressive resistance training, can attenuate or even alleviate this bone loss. Further research incorporating outcomes concerning bone quality and mass are needed to identify the optimal exercise and nutritional regimens to counteract the bone loss.

Keywords:

• Bone
• bone mineral density
• bone markers
• fracture
• older adults
• obesity
• review
• weight loss

Acknowledgments

The contents of this work do not represent the view of the U.S. Department of Veterans Affairs or the United States Government.

Additional information

Funding

This work was supported by the following grants: CX000906, DK109950A, AG031176, and 1-14-LLYQ2 as well as with resources at the Michael E. DeBakey VA Medical Center.